Pancreatology最新文献

{"title":"Relationships between postoperative recurrences and standardized uptake value on 18F-fluorodeoxyglucose-positron emission tomography in patients with resectable and borderline resectable pancreatic ductal adenocarcinoma who underwent curative pancreatic resection after neoadjuvant chemoradiotherapy","authors":"Hironobu Suto ,&nbsp;Mina Nagao ,&nbsp;Hiroyuki Matsukawa ,&nbsp;Takuro Fuke ,&nbsp;Yasuhisa Ando ,&nbsp;Minoru Oshima ,&nbsp;Shigeo Takahashi ,&nbsp;Toru Shibata ,&nbsp;Hideki Kamada ,&nbsp;Hideki Kobara ,&nbsp;Hiroyuki Okuyama ,&nbsp;Tomohiro Hirao ,&nbsp;Kensuke Kumamoto ,&nbsp;Keiichi Okano","doi":"10.1016/j.pan.2024.08.010","DOIUrl":"10.1016/j.pan.2024.08.010","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to examine postoperative recurrence after curative pancreatic resection following neoadjuvant chemoradiotherapy (NACRT) in patients with resectable (R-) and borderline resectable (BR-) pancreatic ductal adenocarcinoma (PDAC), focusing on its relationship with the standardized uptake value (SUV) on ¹⁸F-fluorodeoxyglucose-positron emission tomography (FDG-PET).</div></div><div><h3>Method</h3><div>The postoperative initial recurrence patterns were examined in patients with R- and BR-PDAC who underwent NACRT followed by curative pancreatic resection. Data collected from three prospective clinical trials were retrospectively analysed.</div></div><div><h3>Results</h3><div>After a median follow-up of 29 months, 91 (60 %) of 151 patients experienced postoperative recurrence. The median recurrence-free survival (RFS) for all patients was 18 months. The sites of first recurrence were lung-only in 24 (26 %) patients, liver-only in 23 (25 %), local-only in 11 (12 %), peritoneum-only in 10 (11 %), other single site in 5 (5 %), and multiple sites in 19 (21 %) patients. Multivariate analysis identified the maximum standardized uptake value (SUVmax) on FDG-PET at diagnoses ≥5.40 (hazard ratio [HR], 1.62; 95 % confidence interval [CI], 1.01–2.61; <em>p</em> = 0.045) and node-positive pathology (HR, 2.01; 95 % CI, 1.32–3.08; <em>p</em> = 0.001) as significant predictors of RFS. Furthermore, the SUVmax at initial diagnosis and after NACRT correlated with liver metastasis.</div></div><div><h3>Conclusion</h3><div>R- and BR-PDACs with high SUV on FDG-PET at diagnosis are risk factors for postoperative recurrence. Among patients who undergo surgery after NACRT, those with a high SUVmax at diagnosis or post-NACRT require careful attention for postoperative liver recurrence.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"24 7","pages":"Pages 1133-1140"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142004950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective multicenter surveillance study of branch-duct intraductal papillary mucinous neoplasm of the pancreas; risk of dual carcinogenesis","authors":"Takao Ohtsuka ,&nbsp;Hiroyuki Maguchi ,&nbsp;Shoji Tokunaga ,&nbsp;Susumu Hijioka ,&nbsp;Yukiko Takayama ,&nbsp;Shinsuke Koshita ,&nbsp;Keiji Hanada ,&nbsp;Kentaro Sudo ,&nbsp;Hiroyuki Uehara ,&nbsp;Satoshi Tanno ,&nbsp;Minoru Tada ,&nbsp;Wataru Kimura ,&nbsp;Masafumi Nakamura ,&nbsp;Toshifumi Kin ,&nbsp;Ken Kamata ,&nbsp;Atsushi Masamune ,&nbsp;Takuji Iwashita ,&nbsp;Kazuya Akahoshi ,&nbsp;Toshiharu Ueki ,&nbsp;Keiya Okamura ,&nbsp;Masao Tanaka","doi":"10.1016/j.pan.2024.08.013","DOIUrl":"10.1016/j.pan.2024.08.013","url":null,"abstract":"<div><h3>Background</h3><div>The natural history of branch-duct intraductal papillary mucinous cystic neoplasms (BD-IPMNs) in the pancreas remains unclear. This study aimed to answer this clinical question by focusing on the development of concomitant pancreatic ductal adenocarcinomas (cPDAC).</div></div><div><h3>Methods</h3><div>The Japan Pancreas Society conducted a prospective multicenter surveillance study of BD-IPMN every six months for five years. The primary endpoints were progression of BD-IPMN, progression to high-grade dysplasia/invasive carcinoma (HGD/IC), and cPDAC. Factors predicting the progression of BD-IPMN to HGD/IC and development of cPDAC were also assessed as secondary endpoints.</div></div><div><h3>Results</h3><div>Among the 2104 non-operated patients, 348 (16.5 %) showed progression of primary BD-IPMN. Cumulative incidences of BD-IPMN with HGD/IC and cPDAC during the 5.17-year surveillance period were 1.90 % and 2.11 %, respectively, and standard incidence ratios of BD-IPMN with HGD/IC and cPDAC were 5.28 and 5.73, respectively. Of 38 cPDACs diagnosed during surveillance, 25 (65.8 %) were resectable. The significant predictive characteristics of BD-IPMN for progression to HGD/IC were larger cyst size (p = 0.03), larger main pancreatic duct size (p &lt; 0.01), and mural nodules (p = 0.02). Significant predictive characteristics for the development of cPDAC were male sex (p = 0.03) and older age (p = 0.02), while the size of IPMN was not significant.</div></div><div><h3>Conclusion</h3><div>Careful attention should be given to “dual carcinogenesis” during BD-IPMN surveillance, indicating the progression of BD-IPMN to HGD/IC and development of cPDAC distinct from BD-IPMN, although the establishment of risk factors that predict cPDAC development remains a challenge (UMIN000007349).</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"24 7","pages":"Pages 1141-1151"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142081197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to Letter to Editor by Moyer MT et al regarding ‘EUS guided cyst chemoablation’","authors":"Takao Ohtsuka,&nbsp;Carlos Fernandez-del Castillo","doi":"10.1016/j.pan.2024.09.008","DOIUrl":"10.1016/j.pan.2024.09.008","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"24 7","pages":"Pages 1201-1202"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142178147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor regarding ‘Morbidity and mortality in patients with stage IV pancreatic adenocarcinoma and acute cholangitis: Outcomes and risk prognostication’","authors":"Wenjing Cheng,&nbsp;Majun Zhang","doi":"10.1016/j.pan.2024.08.015","DOIUrl":"10.1016/j.pan.2024.08.015","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"24 7","pages":"Page 1207"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142110809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastroduodenal artery pseudoaneursym in Carcinoma Pancreas post SBRT","authors":"N. Suneetha,&nbsp;Mayadevi Poojari,&nbsp;S. Pratheema,&nbsp;B. Vidya,&nbsp;Subbanna Indushekhar,&nbsp;Shivkumar Swamy,&nbsp;M.S. Belliappa","doi":"10.1016/j.pan.2024.08.017","DOIUrl":"10.1016/j.pan.2024.08.017","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"24 7","pages":"Pages 1208-1210"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142110807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survival analysis of the metastatic cohort of Italian Association of Medical Oncology (AIOM) GARIBALDI survey","authors":"M. Reni ,&nbsp;E. Giommoni ,&nbsp;F. Bergamo ,&nbsp;L. Cavanna ,&nbsp;F. Simionato ,&nbsp;M. Spada ,&nbsp;M. Di Marco ,&nbsp;I. Bernardini ,&nbsp;S.S. Cordio ,&nbsp;T. Latiano ,&nbsp;A. Spallanzani ,&nbsp;N. Silvestris ,&nbsp;G.G. Cardellino ,&nbsp;M. Bonomi ,&nbsp;M. Milella ,&nbsp;G. Luchena ,&nbsp;E. Tamburini ,&nbsp;M. Macchini ,&nbsp;G. Orsi ,&nbsp;M. Modesti ,&nbsp;C. Pinto","doi":"10.1016/j.pan.2024.10.002","DOIUrl":"10.1016/j.pan.2024.10.002","url":null,"abstract":"<div><div>This analysis from the GARIBALDI study was aimed to address the role of center self-declared expertise, type and commitment on the overall survival (OS) of patients with metastatic Pancreatic Ductal Adenocarcinoma (mPDAC).</div><div>Treatment-naïve patients ≥18-year with pathological diagnosis of mPDAC were enrolled. OS was defined as the time from chemotherapy start to death from any cause. The impact of clinical-demographic and centers characteristics on OS was evaluated using Cox models.</div><div>Between July 2017 and October 2019, 473 patients enrolled in 43 centers were eligible for this analysis. Median age was 69.3 (first-third quartile 61.2–74.5); 46.1 % females; 90.8 % ECOG PS 0–1; 67.4 % had liver metastases; median CA19.9700.5 UI/mL (first-third quartile 77.5-6629.5). For 37.1 % of patients chemotherapy started &lt;4 weeks from diagnosis; 69.9 % of patients received nab-paclitaxel + gemcitabine; 16.9 % gemcitabine alone; 7.6 % FOLFIRINOX. The median follow-up was 51.8 months and 428 patients died. No statistically significant role of the type of institution was observed. Additionally, no statistically significant role of neither the self-declared expertise nor the accrual rate was observed.</div><div>The GARIBALDI study suggests that the self-declared center expertise and the academic brand are not associated to OS in patients with mPDAC, while center commitment warrants further exploration.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"24 7","pages":"Pages 1160-1166"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative treatment response prediction for pancreatic cancer by multiple microRNAs in plasma exosomes: Optimization using machine learning and network analysis","authors":"Hiroki Ueda ,&nbsp;Hidenori Takahashi ,&nbsp;Ryoto Sakaniwa ,&nbsp;Tetsuhisa Kitamura ,&nbsp;Shogo Kobayashi ,&nbsp;Yoshito Tomimaru ,&nbsp;Masahiko Kubo ,&nbsp;Kazuki Sasaki ,&nbsp;Yoshifumi Iwagami ,&nbsp;Daisaku Yamada ,&nbsp;Tadafumi Asaoka ,&nbsp;Takehiro Noda ,&nbsp;Junzo Shimizu ,&nbsp;Yuichiro Doki ,&nbsp;Hidetoshi Eguchi","doi":"10.1016/j.pan.2024.09.009","DOIUrl":"10.1016/j.pan.2024.09.009","url":null,"abstract":"<div><h3>Background/objectives</h3><div>MicroRNAs (miRNAs) are involved in chemosensitivity through their biological activities in various malignancies, including pancreatic cancer (PC). However, single-miRNA models offer limited predictability of treatment response. We investigated whether a multiple-miRNA prediction model optimized via machine learning could improve treatment response prediction.</div></div><div><h3>Methods</h3><div>A total of 20 and 66 patients who underwent curative resection for PC after gemcitabine-based preoperative treatment were included in the discovery and validation cohorts, respectively. Patients were classified according to their response to preoperative treatment. In the discovery cohort, miRNA microarray and machine learning were used to identify candidate miRNAs (in peripheral plasma exosomes obtained before treatment) associated with treatment response. In the validation cohort, miRNA expression was analyzed using quantitative reverse transcription polymerase chain reaction to validate its ability to predict treatment response.</div></div><div><h3>Results</h3><div>In the discovery cohort, six and three miRNAs were associated with good and poor responders, respectively. The combination of these miRNAs significantly improved predictive accuracy compared with using each single miRNA, with area under the curve (AUC) values increasing from 0.485 to 0.672 to 0.909 for good responders and from 0.475 to 0.606 to 0.788 for poor responders. In the validation cohort, improved predictive performance of the miRNA combination over single-miRNA prediction models was confirmed, with AUC values increasing from 0.461 to 0.669 to 0.777 for good responders and from 0.501 to 0.556 to 0.685 for poor responders.</div></div><div><h3>Conclusions</h3><div>Peripheral blood miRNA profiles using an optimized combination of miRNAs may provide a more advanced prediction model for preoperative treatment response in PC.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"24 7","pages":"Pages 1097-1106"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142252011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to Letter to Editor by Büchler and Neoptolemos regarding ‘The duodenum-preserving head resection for chronic pancreatitis’","authors":"Biju Pottakkat,&nbsp;S. Harilal,&nbsp;R. Kalayarasan,&nbsp;P Sai Krishna","doi":"10.1016/j.pan.2024.09.007","DOIUrl":"10.1016/j.pan.2024.09.007","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"24 7","pages":"Pages 1205-1206"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142351779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of explainable artificial intelligence in guiding the management of patients with a pancreatic cyst","authors":"Juan M. Lavista Ferres ,&nbsp;Felipe Oviedo ,&nbsp;Caleb Robinson ,&nbsp;Linda Chu ,&nbsp;Satomi Kawamoto ,&nbsp;Elham Afghani ,&nbsp;Jin He ,&nbsp;Alison P. Klein ,&nbsp;Mike Goggins ,&nbsp;Christopher L. Wolfgang ,&nbsp;Ammar A. Javed ,&nbsp;Rahul Dodhia ,&nbsp;Nick Papadopolous ,&nbsp;Ken Kinzler ,&nbsp;Ralph H. Hruban ,&nbsp;William B. Weeks ,&nbsp;Elliot K. Fishman ,&nbsp;Anne Marie Lennon","doi":"10.1016/j.pan.2024.09.001","DOIUrl":"10.1016/j.pan.2024.09.001","url":null,"abstract":"<div><h3>Background/objectives</h3><div>Pancreatic cyst management can be distilled into three separate pathways – discharge, monitoring or surgery– based on the risk of malignant transformation. This study compares the performance of artificial intelligence (AI) models to clinical care for this task.</div></div><div><h3>Methods</h3><div>Two explainable boosting machine (EBM) models were developed and evaluated using clinical features only, or clinical features and cyst fluid molecular markers (CFMM) using a publicly available dataset, consisting of 850 cases (median age 64; 65 % female) with independent training (429 cases) and holdout test cohorts (421 cases). There were 137 cysts with no malignant potential, 114 malignant cysts, and 599 IPMNs and MCNs.</div></div><div><h3>Results</h3><div>The EBM and EBM with CFMM models had higher accuracy for identifying patients requiring monitoring (0.88 and 0.82) and surgery (0.66 and 0.82) respectively compared with current clinical care (0.62 and 0.58). For discharge, the EBM with CFMM model had a higher accuracy (0.91) than either the EBM model (0.84) or current clinical care (0.86). In the cohort of patients who underwent surgical resection, use of the EBM-CFMM model would have decreased the number of unnecessary surgeries by 59 % (n = 92), increased correct surgeries by 7.5 % (n = 11), identified patients who require monitoring by 122 % (n = 76), and increased the number of patients correctly classified for discharge by 138 % (n = 18) compared to clinical care.</div></div><div><h3>Conclusions</h3><div>EBM models had greater sensitivity and specificity for identifying the correct management compared with either clinical management or previous AI models. The model predictions are demonstrated to be interpretable by clinicians.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"24 7","pages":"Pages 1182-1191"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142223534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single double pigtail plastic stent (DPT) is equally effective to two double pigtail plastic stents for endoscopic ultrasonography-guided drainage of \"symptomatic peripancreatic fluid collection with 30 % or less necrotic debris\"","authors":"Hemanta Kumar Nayak,&nbsp;Shubham Gupta,&nbsp;Manas Kumar Panigrahi,&nbsp;Abhijeet Rai,&nbsp;Saswati Kar,&nbsp;Mansi Chaudhary,&nbsp;Ajay Ghosh,&nbsp;Taraprasad Tripathy,&nbsp;Bramhadatta Pattnaik,&nbsp;Subash Chandra Samal","doi":"10.1016/j.pan.2024.09.017","DOIUrl":"10.1016/j.pan.2024.09.017","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"24 7","pages":"Pages 1211-1212"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142375742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}